{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T02:15:49Z","timestamp":1740104149300,"version":"3.37.3"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T00:00:00Z","timestamp":1699574400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>This retrospective observational cohort study aimed to assess the real\u2010life application of bronchial challenge test (BCT) in the management of preschool children presenting with atypical recurrent respiratory symptoms (ARRS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included children aged 0.5\u20136 years referred to a pediatric\u2010pulmonology clinic who underwent BCT using methacholine or adenosine between 2012 and 2018 due to ARRS. BCT was considered positive based on spirometry results and\/or wheezing, desaturation, and tachypnea reactions. We collected data on demographics, BCT results, pre\u2010BCT and post\u2010BCT treatment changes, and 3\u20136 months post\u2010BCT compliance and symptom control. The primary outcome measure was the change in treatment post\u2010BCT (step\u2010up or step\u2010down).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 228 children (55% males) with a mean age of 4.2\u2009\u00b1\u20090.6 years underwent BCT (52% adenosine\u2010BCT, 48% methacholine\u2010BCT). Children referred for methacholine were significantly younger compared with adenosine (3.6\u2009\u00b1\u20091.2 vs. 4.2\u2009\u00b1\u20091.2 years, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01). Methacholine and adenosine BCTs were positive in 95% and 61%, respectively. Overall, changes in management were observed in 122 (53.5%) children following BCT, with 83 (36.4%) being stepped up and 37 (17%) being stepped down. Significantly more children in the methacholine group were stepped up compared with the adenosine group (46% vs. 28%, <jats:italic>p<\/jats:italic>\u2009=\u2009.004). During the follow\u2010up assessment, we observed a clinical improvement in 119\/162 (73.4%) of the children, with nearly 87% being compliant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study demonstrates the importance of BCT in the management of preschool children presenting to pediatric pulmonary units with ARRS. The change in treatment and subsequent clinical improvement observed highlight the added value of BCT to the pulmonologist.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.26754","type":"journal-article","created":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T10:48:50Z","timestamp":1699613330000},"page":"355-361","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The role of bronchial challenge test in guiding therapy in preschool children with atypical recurrent respiratory symptoms"],"prefix":"10.1002","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3723-3542","authenticated-orcid":false,"given":"Yonatan","family":"Wolfson","sequence":"first","affiliation":[{"name":"Pediatric Pulmonology Unit The Edith Wolfson Medical Center Holon Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Avigdor","family":"Mandelberg","sequence":"additional","affiliation":[{"name":"Pediatric Pulmonology Unit The Edith Wolfson Medical Center Holon Israel"},{"name":"Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tal","family":"Golan\u2010Lagziel","sequence":"additional","affiliation":[{"name":"Pediatric Pulmonology Unit The Edith Wolfson Medical Center Holon Israel"},{"name":"Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne","family":"Sosnovsky","sequence":"additional","affiliation":[{"name":"Pediatric Pulmonology Unit The Edith Wolfson Medical Center Holon Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorit","family":"Ater","sequence":"additional","affiliation":[{"name":"Pediatric Pulmonology Unit Assuta Ashdod hospital Ashdod Israel"},{"name":"Faculty of Health Sciences Ben\u2010Gurion University of the Negev Beer Sheva Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keren Armoni","family":"Domany","sequence":"additional","affiliation":[{"name":"Pediatric Pulmonology Unit The Edith Wolfson Medical Center Holon Israel"},{"name":"Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,11,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2014.04.130276"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2018.00186"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.14.0170"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.82.suppl_2.ii2"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2012.04.025"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/02770903.2018.1424194"},{"issue":"5","key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"S94","DOI":"10.1016\/j.jaci.2007.09.029","article-title":"Expert panel report 3 (EPR\u20103): guidelines for the diagnosis and management of asthma\u2010summary report 2007","volume":"120","author":"National Asthma Education and Prevention Program","year":"2007","journal-title":"J Allergy Clin Immunol"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.3132\/pcrj.2009.00008"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/prrv.2000.0042"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(88)80177-X"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/pai.13767"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-0116"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.50.5.511"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3038.2006.00411.x"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.25614"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.24337"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2012.02590.x"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.26462"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.162.3.9910037"},{"key":"e_1_2_10_21_1","unstructured":"Laerd Statistics. 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